title: Palliative care physicians' practices and attitudes regarding advance care planning in palliative care units in Japan: a nationwide survey.
abstract: To clarify physicians' practices and attitudes regarding advance care planning (ACP) in palliative care units (PCUs) in Japan, we conducted a self-completed questionnaire survey of 203 certificated PCUs in 2010. Ninety-nine physicians participated in the survey. Although most Japanese palliative care physicians recognized the importance of ACP, many failed to implement aspects of patient-directed ACP that they acknowledged to be important, such as recommending completion of advance directives (ADs), designation of health care proxies, and implementing existing ADs. The physicians' general preference for family-centered decision making and their feelings of difficulty and low confidence regarding ACP most likely underlie these results. The discrepancy between physicians' practices and their recognition of the importance of ACP suggests an opportunity to improve end-of-life care.
authors.affiliation: Department of Primary Care and Medical Education, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nakazawa
authors.affiliation: Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan kizawa-ysyk@umin.org.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kizawa
authors.affiliation: Department of Primary Care and Medical Education, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
authors.forename: Takami
authors.initials: T
authors.lastname: Maeno
authors.affiliation: Department of Primary Care and Medical Education, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Takayashiki
authors.affiliation: Department of Palliative Care, Asahikawa Medical University, Asahikawa, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Department of Primary Care and Medical Education, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Hamano
authors.affiliation: Department of Primary Care and Medical Education, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Maeno
mesh_terms: D000328:Adult; D032722:Advance Care Planning; D016223:Advance Directives / Q000523:psychology* / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D017051:Hospice Care / Q000523:psychology*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology*; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology*; D055815:Young Adult
keywords: Japan; advance care planning; advance directives; attitude; neoplasms; palliative care; palliative medicine